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And learned some dark shit in the process.
In 2006 I had a really, really bad year. My older daughter got sick and nearly died, my younger daughter got depressed, and my beloved mother-in-law developed terminal lung cancer. For weeks all I could do was cry and panic and cry some more.
When a psychiatrist suggested I take a small dose of lorazepam (the generic name for Ativan) three times a day, I said yes please. The relief was immediate: I could sleep. I could think. I could cope with the multiple traumas our family was facing.
I was in good company. According to a new report based on government data, one in five American women (and one in ten men) has taken at least one psychiatric medication, mostly antidepressants or anti-anxiety drugs like Ativan. And most of these patients take the meds regularly, many for years and years. Like me.
Our annus horribilis eventually came to an end: My daughters got better and my mother-in-law died. But eight years later I was still slipping a tiny white pill under my tongue three times a day, and I wanted to stop. I asked my doctor if he could help me get off it, and his response, more or less, was "If it ain't broke, don't fix it."
The thing was, it was sort of broke. My once-excellent memory had become unreliable. I felt dull and stupid. My balance got so wobbly I tripped over nothing one day and face-planted myself into a broken nose. The doc reassured me that the class of medications known as benzodiazepines were benign, but I was reading research linking benzos with dementia, memory loss, falls, and overdoses.
Some percentage of people who've taken benzos for more than a few weeks can stop cold turkey and have no problems. But I knew I wasn't one of them. Whenever I was late with a dose I'd feel my anxiety spike and my heart pound. After eight years I'd become physically dependent on the drugs. Getting off them wasn't going to be easy.
When you can't sleep or eat or breathe without feeling like you're about to die, you'll do pretty much anything to make it stop. Benzos really are a miracle drug in that moment.
Benzodiazepines were the pharmaceutical miracle of the 1960s. Librium, Valium, and other benzos were prescribed for everything from insomnia to seizures, and by the late 1970s they were the most prescribed medication in the world.
"There are plenty of appropriate uses for them," says Joseph Lee, medical director of the Hazelden Betty Ford Foundation Youth Continuum. He names seizure disorders, catatonia, and life-threatening withdrawal from alcohol and other sedatives.
But by far the most common reason benzos are prescribed is for anxiety. And I get why. When you've gone a week or two with your body and brain in panic mode, when you can't sleep or eat or breathe without feeling like you're about to die, you'll do pretty much anything to make it stop. Benzos really are a miracle drug in that moment.
Unfortunately, for most people those miraculous anti-anxiety effects last only a few weeks or, if you're lucky, months. In one of the few studies ever done on the long-term effectiveness of benzos, people who took Xanax to manage anxiety did worse after eight weeks than people who took a placebo. "That finding has never been repeated because nobody will fund it," says Reid Finlayson, an associate professor of clinical psychiatry and behavioral sciences at Vanderbilt University in Nashville.
People who took Xanax to manage anxiety did worse after eight weeks than people who took a placebo.
Doctors keep right on writing scrips for benzos for years, even decades, despite the fact that they're linked to treatment-resistant depression, suicide, cognitive impairment, Alzheimer's disease and other dementias, and traffic accidents. The number of benzodiazepine prescriptions in the US has tripled in the past two decades. A 2015 study showed that more than 5 percent of the US population filled prescriptions for benzos; up to a third of them were long-term users (this despite the fact that the label usually recommends otherwise).
When I contacted Pfizer, makers of Xanax, with questions about the longterm use of their drug, a rep there offered this bland statement: "When prescribed and taken as indicated, Xanax is an important treatment option for patients. As with all our medicines, Xanax should be administered in accordance with local product labeling. Patients who have questions should speak with their healthcare provider."
Ideally, says, Thomas L. Schwartz, a professor of psychiatry at SUNY Upstate Medical University in Syracuse, New York, benzodiazepines aren't the go-to treatment for treating anxiety. "Classically a patient is treated with psychotherapy, an SSRI, or an SNRI," he explains. "After these three things fail, a benzo is allowed per most treatment guidelines for many of the anxiety disorders."
Schwartz feels that for some people, benzos remain effective long term. "I have some patients I have seen since 2000 and their [anti-anxiety effects] have not worn off," he says. My question is, how can you tell? My doctor certainly thought benzos were still working for me. But after eight years I wasn't so sure.
I felt a deep sense of shame about using lorazepam, despite the fact that I'd taken it only as prescribed. I'd never upped my dose or popped a handful for fun or gone doctor-shopping for more. I didn't particularly like the way it made me feel. I didn't think it was doing much for my anxiety, either; an antidepressant now took care of that.
I went online to find out how to get off the meds, and what I read freaked me out. There were whole websites devoted to supporting people who were tapering themselves off the drug because no doctor could or would help. Some of them had been at it for months or years. Many struggled with such profound symptoms they'd become disabled. "It's incredibly hard to get off benzos, and it has nothing to do with addiction," Lee says. "It just has to do with physiologic dependence."
One of those long-term patients was Christy Huff, a cardiologist in Fort Worth, Texas. Huff was prescribed daily Xanax after dry eye syndrome made it impossible for her to sleep. It worked for a few weeks, but then she started to develop anxiety during the day, which she'd never had before. She needed more and more Xanax; she thought she was going crazy. She had no idea what was going on until a psychologist asked her to stop the Xanax for 12 hours before a biofeedback session. "My whole chest clamped down," remembers Huff. "I couldn't breathe. Suddenly it was like, Wait a second, this is not anxiety—I'm dependent on this stuff."
Cannabis has been used as an all-purpose homeopathic remedy for centuries. Over time, evidence suggests that the plant was an herbal remedy for psycho-neurological disorders, breast cancer, rheumatism, sexual disorders, and painful complications related to childbirth. Now, this ancient tool has a new, modern application. A cannabis patch is now available for patients with fibromyalgia and diabetic nerve pain.
Cannabis for fibromyalgia & nerve pain
Cannabis Science designs an infused pain patch
Post Polio Litaff, Association A.C _APPLAC Mexico
At six-years-old, Bobby Doherty from Belfast wasn't playing or riding his bike - he was lying entombed in plaster from head-to-foot in Musgrave Park Hospital after contracting polio.
'Fear of wasps'
Post Polio Litaff, Association A.C _APPLAC Mexico
Poliovirus research offers insights into other viruses that impact global health
In the decades since Dr. Jonas Salk developed the first polio vaccine, cases of polio have exponentially declined. Though once widespread epidemic, the highly infectious childhood disease is now close to global eradication.
The question remains: why would researchers spend time and resources studying a virus already on the brink of total eradication?
|Synonyms and related keywords: PPS|
History: Symptoms usually appear earlier in patients who have very severe residual weakness, early bulbar respiratory difficulty in the acute illness, and those who were older when they contracted acute polio. PPS symptoms tend to occur first in the weaker muscles.
- Fatigue: In individuals without polio or PPS, the functional consequences of aging and loss of motor units may be unnoticeable until a very advanced age. In the individual with PPS, any further loss of strength may be more readily apparent. In contrast to patients with chronic fatigue syndrome, postpolio fatigue is prominent in the early hours of the afternoon and decreases after brief periods of rest. PPS-related fatigue usually does not prevent patients from working.
- Pathogenesis can include chronic pain, type A personality, depression, dysfunctional reticular-activated system, sleep disorders, and respiratory dysfunction.
- PPS produces somnolence and difficulty in concentrating and remembering.
- Pathogenesis may be metabolic exhaustion of the enlarged motor units, neuromuscular junction transmission defects, scarring within the motor neurons, or loss of motor units due to aging.
- PPS produces decreased muscular endurance and increased muscular fatigability.
- A number of functional etiologies for weakness have been hypothesized, including disuse, overuse, and chronic weakness, as well as weight gain.
- Asymmetric and scattered weakness may be present.
- Some authors have found evidence that previously unaffected muscles later become weak; in these cases, they discovered that the patient was unaware or had not been told that the particular muscle had been affected during the acute episode.
- Muscle pain
- Deep aching pain may be a component of a myofascial pain syndrome or fibromyalgia.
- This feature is extremely prevalent in PPS.
- Gait disturbance: Difficulty with gait is caused by progressive weakness, pain, osteoarthritis, or joint instability; it is common in patients who previously used assistive devices but later discarded them.
- Respiratory problems
- Respiratory disorders are most prevalent in patients with residual respiratory muscle weakness.
- These changes cause chronic microatelectasis, diminished pulmonary compliance, increased chest wall tightness, chronic alveolar hypoventilation, decreased cough and expiratory flow, and decreased clearing of secretions.
- The new respiratory difficulties are not only related to new respiratory muscle weakness but also to scoliosis, pulmonary emphysema, cardiovascular insufficiency, or poor posture.
- A central component also may occur because acute bulbar polio often affects the medullary structures, including the reticular formation and sleep regulatory system.
- Swallowing problems
- These difficulties can occur in patients with bulbar and nonbulbar postpolio.
- Subclinical asymmetrical weakness in the pharyngeal constrictor muscles is almost always present in all postpolio muscular atrophy (PPMA) patients, including those who do not complain of new swallowing difficulties.
- Autonomic dysfunction: The cause is unclear; the peripheral component could include muscular atrophy and, therefore, diminished heat production.
- Sleep apnea
- This disorder is not uncommon in patients left with residual bulbar dysfunction or severe respiratory compromise.
- Sleep apnea appears to be due to a combination of the following:
- Central apnea, due to a residual dysfunction of the surviving bulbar reticular neurons
- Obstructive apnea, due to pharyngeal weakness and increased musculoskeletal deformities from scoliosis or emphysema
- PPMA, resulting in diminished muscle strength of the respiratory, intercostal, and abdominal muscle groups
- Flat back syndrome
- Another possible symptom in some patients with PPS is the flat back syndrome, which consists of the inability to stand erect because of forward flexion of the trunk and pain in the low back and legs.
- The flat back syndrome typically occurs in patients with diminished lumbar lordosis as a result of instrumentation of the spine for scoliosis, vertebral fracture, or degenerative joint disease.
- The trunk extensor musculature plays an essential role in maintaining upright posture, and it may be that PPS-related weakness in this musculature represents a major contributing factor to the flat back syndrome in these patients.
Physical: Progressive weakness and atrophy may be observed in muscles that were affected initially by the poliovirus or in muscles that were spared clinically, which tends to happen in an asymmetric distribution. Fasciculations sometimes can be observed in atrophic muscles, as a result of the lower motor neuron injury.
|Author: Flor M Muñiz, MD, Staff Physician, Department of Physical Medicine and Rehabilitation, Thomas Jefferson UniversityCoauthor(s): Gerald Herbison, MD, Clinical Professor, Department of Physical Medicine and Rehabilitation, Thomas Jefferson University|
|Flor M Muñiz, MD, is a member of the following medical societies: American Medical Association|
|Editor(s): Martin K Childers, DO, Associate Professor, Department of Physical Medicine and Rehabilitation, University of Missouri School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, Pharmacy, eMedicine; Kat Kolaski, MD, Adjunct Clinical Assistant Professor, Department of Pediatrics, University of North Carolina; Director, Pediatric and Adolescent Rehabilitation, Charlotte Institute of Rehabilitation; Kelly L Allen, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Lourdes Regional Rehabilitation Center, Our Lady of Lourdes Medical Center; and Denise I Campagnolo, MD, MS, Clinical Director of Spinal Cord Injury Program, Associate Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School|
Post Polio Litaff, Association A.C _APPLAC Mexico
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THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/